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Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem, characterized by a dense network of relationships among public and private organizations (hospitals, companies and universities) as well as other actors that can be labeled as “untraditional” player, i.e. doctors, nurses and patients. The purpose of this paper is to cover this gap and explore how knowledge is transferred and flows among all the healthcare ecosystems’ players in order to support open innovation processes.

The paper is conceptual in nature and adopts a narrative literature review approach. In particular, insights gathered from open innovation literature at the inter-organizational network level, with a particular attention to healthcare ecosystems, and from the knowledge transfer processes, are analyzed in order to propose an interpretative framework for the understanding of knowledge transfer in open innovation with a focus on healthcare ecosystem.

The paper proposes an original interpretative framework for knowledge transfer to support open innovation in healthcare ecosystems, composed of four main components: healthcare ecosystem’s players’ categories; knowledge flows among different categories of players along the exploration and exploitation stages of innovation development; players’ motivations for open innovation; and players’ positions in the innovation process. In addition, assuming the intermediary network as the suitable organizational model for healthcare ecosystem, four classification scenarios are identified on the basis of the main players’ influence degree and motivations for open innovation.

The paper offers interpretative lenses for managers and policy makers in understanding the most suitable organizational models able to encourage open innovation in healthcare ecosystems, taking into consideration the players’ motivation and the knowledge transfer processes on the basis of the innovation results.

The paper introduces a novel framework that fills a gap in the innovation management literature, by pointing out the key role of external not R&D players, like patients, involved in knowledge transfer for open innovation processes in healthcare ecosystems.

There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs).

The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed.

The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations.

In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities.

Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring.

This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public policy making. A better understanding of ISs in general, and in healthcare in particular, may provide the basis for designing and evaluating innovation policy.

The present article aims at rising stream of literature about intellectual capital in healthcare organizations, by exploring how knowledge-based activities are designed to promote innovation and create value. This process concerns not only buyers and sellers of industrial products/services but, more widely, larger networks of healthcare actors which include patients, payers and health institutions.

To answer the research question, we adopted a conceptual approach aimed at reaching overall comprehension of healthcare innovation mechanisms. We have tracked the pivotal extant studies for catching the roots and dynamics at the base of diffusion of healthcare innovation. This article demonstrates, based on previous literature and theoretical speculations, the contribution that innovative knowledge-based activities (e.g. market access approach) make to intellectual capital in healthcare organizations to promote innovation and create value.

The results show that three knowledge-based activities of the healthcare ecosystem shape the basis of the proposed conceptual framework. First, a value co-creation strategy to develop capabilities for each health stakeholder is intended as human capital. Second, the market access approach to promote innovation is reported to the relational capital. Third, a digital servitization strategy is referred to the structural capital.

This paper provides implications for the stream of literature about intellectual capital in healthcare organizations. It aims at exploring three knowledge-based activities as value co-creation, market access and digital servitization that respond to different intellectual capital levels components (human, relational, structural).

This article provides a conceptual framework based on the linkage of two fundamental streams of management studies, which correspond to innovation diffusion and intellectual capital management. This offers a more solid conceptualization for managing intellectual capital in healthcare organizations with respect to previous studies and creates value in the ecosystem.

The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly aims to examine how patient narratives, in the form of diaries and radio montage, help to create new insights into patient experience for healthcare professionals, and support professionals’ enrolment and mobilisation in innovation projects.

Two case studies were undertaken. These drew upon qualitative interviews with staff and participant observation during innovation workshops. Patient diaries and a recorded montage of patient voices were also collected.

The findings illuminate translation processes in healthcare innovation and the emergence of meaning making process for staff through the active use of patient narratives. The paper highlights the critical role of meaning making as an enabler of patient-centred change processes in healthcare via: local clinic mangers defining problems and ideas; collecting and sharing patient narratives in innovation workshops; and healthcare professionals’ interpretation of patient narratives supporting new insights into patient experience.

This study demonstrates how healthcare professionals’ meaning making can be supported by articulating, constructing, listening and interpreting patient narratives. The two cases demonstrate how patient narratives serve as reflective devices for healthcare professionals.

This study presents a novel demonstration of the importance of patient narratives for translating healthcare innovation in a clinical practice setting.

This paper reports from a qualitative case study of a change initiative undertaken in a Danish public hospital setting during national healthcare reforms. The purpose of this paper is to challenge understandings of innovations as defined by being value-adding per se. Whether the effects of attempting to innovate are positive or negative is in this paper regarded as a matter of empirical investigation.

Narrative accounts of activities during the change initiative are analysed in order to elucidate the effects of framing the change initiative as innovation on which boundaries are created and crossed.

Framing change initiatives as innovation leads to intended as well as unanticipated boundary crossings where healthcare practitioners from different organizations recognize a shared problem and task. It also leads to unintended boundary reinforcements between “us and them” that may exclude the perspectives of patients or stakeholders when confronting complex problems in healthcare. This boundary reinforcement can lead to further fragmentation of healthcare despite the stated intention to create more integrated services.

The paper suggests that researchers as well as practitioners should not presume that intentions to innovate will by themselves enhance creativity and innovation. When analysing the intended, unintended as well as unanticipated consequences of framing change initiatives as innovation, researchers and practitioner gain nuanced knowledge about the effects of intending to innovate in complex settings such as healthcare.

This paper suggests the need for an analytical move from studying the effects of innovation to studying the effects of framing complex problems as a call for innovation.

The purpose of this paper is to examine innovation in the resource-constrained context of India’s healthcare industry. It is argued that the process of innovation in addressing healthcare management challenges in such a context occurs through organisational ambidexterity and that human resource management (HRM) plays an important role.

A qualitative research methodology is applied to explore the role of HR practices in facilitating contextual ambidexterity and subsequent innovations in healthcare in India. The unit of analysis is the “case” of healthcare providers in India and in-depth interview and documentary data in two case sites are analysed to reveal the role of HRM in facilitating contextual ambidexterity and innovation. Data analysis was undertaken first at a within-case and then at a cross-case analysis level using interpretive manual coding based on how the data explained the role of HRM in delivering innovative outcomes and supporting organisational ambidexterity.

The authors found evidence of the use of sets of high-involvement HRM practices for exploration of new ideas and efficiency-driven HRM practices for creating contextual ambidexterity in the case organisations. Further, managerial/leadership style was found to play an important role in creating cultures of trust, openness, risk-taking and employee empowerment, supported by an appropriate mix of intrinsic and extrinsic rewards. Finally, training was also reported as being central to creating an ambidextrous context for delivering on various innovations in these healthcare providers.

This study represents an exploration of innovation in the context of India’s healthcare sector through intersecting literatures of ambidexterity, innovation and HRM practices. In light of the emerging economy research context, an important empirical contribution is palpable. Moreover, through a study design which included collecting data from multiple informants on the role of human resources in facilitating innovative outcomes, the authors reveal the role of HR-related initiatives, beyond formal HR practices in creating contextual ambidexterity. This study also reveals the degree to which contextual idiosyncrasies enhance our understanding of the role of HR in facilitating innovation in emerging economies.

The purpose of this paper is to question whether the emphasis placed within translational research on a linear model of innovation provides the most effective model for managing health technology innovation. Several alternative perspectives are presented that have potential to enhance the existing model of translational research. A case study is presented of innovation of a clinical decision support system. The paper concludes from the case study that an extending the triple helix model of technology transfer, to one based on a quadruple helix, present a basis for improving the performance translational research.

A case study approach is used to help understand development of an innovative technology within a teaching hospital. The case is then used to develop and refine a model of the health technology innovation system.

The paper concludes from the case study that existing models of translational research could be refined further through the development of a quadruple helix model of heath technology innovation that encompasses greater emphasis on user-led and open innovation perspectives.

The paper presents several implications for future research based on the need to enhance the model of health technology innovation used to guide policy and practice.

The quadruple helix model of innovation that is proposed can potentially guide alterations to the existing model of translational research in the healthcare sector. Several suggestions are made for how innovation activity can be better supported at both a policy and operational level.

This paper presents a synthesis of the innovation literature applied to a theoretically important case of open innovation in the UK National Health Service. It draws in perspectives from other industrial sectors and applies them specifically to the management and organisation of innovation activities around health technology and the services in which they are embedded.

Developing technological innovations in healthcare is made complex and difficult due to effects upon the practices of professional, managerial and other stakeholders. Drawing upon the concept of boundary object, this paper explores the challenges of achieving effective collaboration in the development and use of a novel healthcare innovation in the English healthcare system.

A case study is presented of the development and implementation of a smart phone application (app) for use by rheumatoid arthritis patients. Over a two-year period (2015–2017), qualitative data from recorded clinical consultations (n = 17), semi-structured interviews (n = 63) and two focus groups (n = 13) were obtained from participants involved in the app's development and use (clinicians, patients, researchers, practitioners, IT specialists and managers).

The case focuses on the use of the app and its outputs as a system of inter-connected boundary objects. The analysis highlights the challenges overcome in the innovation's development and how knowledge sharing between patients and clinicians was enhanced, altering the nature of the clinical consultation. It also shows how conditions surrounding the innovation both enabled its development and inhibited its wider scale-up.

By recognizing that technological artefacts can simultaneously enable and inhibit collaboration, this paper highlights the need to overcome tensions between the transformative capability of such healthcare innovations and the inhibiting effects simultaneously created on change at a wider system level.

The purpose of this paper is to explore, through a case study, and using Pawson and Tilley's notion of context-mechanism-outcome configurations, how a sectoral innovation system (SIS) for health technologies has developed.

The case study data were collected as part of a large study that looked at technology innovation and adoption in the UK's National Health Service and were collected using an interpretive case study methodology. Primary data came from interviews and secondary data from published sources, including articles authored by members of the innovation team.

The paper identifies three specific configurations of context, mechanism and outcome that were important in the case and discusses how these contribute to a broader understanding of a healthcare services SIS.

Research conducted through a single case study is open to the criticism that its findings are not generalisable but it has offered an economical way of gaining a deep description of a situation and an understanding of the contextual factors affecting a phenomenon. The paper presents a refined model for understanding SISs that though primarily rooted within the healthcare care sector has potential for application in other sectors, especially those that encompass a significant public-sector component.

The paper's findings and conclusions have relevance to healthcare service innovation policy development. The findings will also be useful to professionals responsible for innovation projects and their support within the sector.

The paper makes an important contribution to the understanding of a SIS for healthcare services as well as refining a general model of SISs.

Worldwide, healthcare systems struggle to sustain the delivery of services at a time of increasing demand, limited resources and growing expectations from users, coupled with dealing with the aftermath of the Covid-19 pandemic and the threat of other outbreaks. There has never been a more important time to sustain innovation and improvements. Using an illustrative case, the authors assess the application of two existing frameworks to identify the key propositions and dimensions required to deliver sustainable services.

This illustrative case study focuses on a service provided by a chronic disease, multidisciplinary community healthcare team in the UK. Experienced-based interviews were conducted with health professionals, patients and relatives to provide a rich account of a care pathway design. A high-level process map is used to visualise the key touch points.

The authors identify all seven propositions of the SERVICE framework being present along with additional dimensions relating to sustaining innovation and improvement.

This research is limited to a chronic disease care pathway. However, the authors believe the results could be applicable to other medical conditions, which are supported by a similar multi-disciplinary service delivery model.

The authors provide a sustainable public service operations SERVICES framework for health professionals and managers to consider when (re)designing care pathways.

This research contributes to the emerging discipline of public service operations research by empirically testing for the first time the SERVICE framework within healthcare. The authors have included additional factors associated with innovation and improvement and recommended further development of the framework to include factors, such as economic sustainability, highly relevant to the context of universal healthcare systems.